# Strengths-Based Multi-Level Behavioral Intervention to Promote Resilience and Self-Management in Youth with Type 1 Diabetes

> **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2022 · $780,475

## Abstract

PROJECT SUMMARY/ABSTRACT
Type 1 diabetes (T1D) management is particularly challenging during the transition to adolescence, as this
developmental period is often marked by increasing expectations for independence in self-management and
poorer glycemic and quality of life outcomes. In behavioral T1D research (largely conducted with adolescents),
there has been limited evidence of meaningful, lasting impact on adherence behaviors or glycemic outcomes.
Novel, developmentally appropriate approaches are needed to help youth achieve “diabetes resilience” – i.e.,
engage in high levels of self-management behaviors, achieve HbA1c levels within the target range, and
experience good quality of life – during the important late childhood and early adolescent years. Prevention
science and social-ecological theories of health behavior change for pediatric health conditions recognize the
importance of early interventions that target multiple systems surrounding a child with a chronic condition like
T1D to promote trajectories of positive behavioral, psychosocial, and medical outcomes. The goal of this study
is to evaluate a new intervention for youth age 8-12 with T1D and elevated HbA1c that uses strengths-based
methods to prevent the deterioration in outcomes often observed in adolescence. In this 6-month, multi-modal
intervention: (1) diabetes care providers will use youth- and parent-reports of youth’s diabetes strengths and
self-management behaviors to lead a discussion of what youth are doing well for T1D during a routine diabetes
care appointment, (2) parents will use an app to recognize, track, and reinforce their children’s positive T1D-
related behaviors and will have “3 minute meetings” with their child about a T1D self-management goal, and (3)
youth will use an app to have positive interactions with parents about their diabetes strengths and build
supportive social connections with peers through videos about living well with T1D. The intervention strategies
are brief, low-burden, and use digital health technologies to deliver the intervention in the context of real-world
diabetes activities (i.e., routine medical appointments and everyday T1D management). We will test this
intervention with 250 racially/ethnically, socioeconomically, and linguistically diverse youth in Houston, TX and
Washington, DC, who are randomly assigned to the intervention or enhanced usual care. Our goal is to evaluate
the intervention’s impact on key T1D outcomes: HbA1c, % glucose time in range, engagement in T1D self-
management behaviors, and health-related quality of life. We will also examine psychosocial and intervention-
specific factors that may be mechanisms of the intervention’s effect. Data will be collected for 15 months. The
ultimate goal of this research is to test the effects of a multi-level, strengths-based preventive intervention on
health behaviors, psychosocial well-being, and T1D health outcomes during the critically important and
understudied developmental...

## Key facts

- **NIH application ID:** 10522297
- **Project number:** 1R01DK131350-01A1
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Marisa Ellen Hilliard
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $780,475
- **Award type:** 1
- **Project period:** 2022-07-20 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10522297

## Citation

> US National Institutes of Health, RePORTER application 10522297, Strengths-Based Multi-Level Behavioral Intervention to Promote Resilience and Self-Management in Youth with Type 1 Diabetes (1R01DK131350-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10522297. Licensed CC0.

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